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FORMULIR REGISTRASI DANAMAS INDIVIDU BADAN HUKUM    Nama Lengkap Individu     sesuai KTP/Paspor/SIM :       Tipe Identitas :   KTP Paspor SIM    No. Identitas :      Tanggal Di Keluarkan :   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr Mei Jun Jul Agt Sep Okt Nov Des    Tanggal Akhir Berlaku :   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr Mei Jun Jul Agt Sep Okt Nov Des    Pekerjaan :   [Pilih Satu] Akunting/Keuangan Wiraswasta Komputer (Manajemen) Komputer (Internet) Konsultan Customer service/Support Pendidikan/Pelatihan Teknik Eksekutif Administrasi Umum/Supervisor Pemerintah/Militer Manufaktur/Produksi/Operasi Professional(medis, hukum, dsb.) Litbang Pensiunan Penjualan/Pemasaran/Periklanan Mahasiswa/Pelajar Tidak Bekerja Lainnya     :    Tempat Lahir :      Tanggal Lahir :   01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr Mei Jun Jul Agt Sep Okt Nov Des    Kewarganegaraan :    Indonesia       Lainnya    Jenis Kelamin :      Pria     Wanita    Status Pernikahan :   Belum Menikah Sudah Menikah    Alamat :             Kota :      Propinsi :   DKI Jakarta Aceh Bali Bengkulu Daerah Istimewa Yogyakarta Irian Jaya Kalimantan Barat Kalimantan Tengah Kalimantan Timur Nusa Tenggara Barat Nusa Tenggara Timur Jambi Jawa Barat Jawa Tengah Jawa Timur Kalimantan Selatan Lampung Maluku Sulawesi Selatan Sulawesi Utara Sumatera Selatan Sumatera Utara Riau Sulawesi Tengah Sulawesi Tenggara Sumatera Barat Luar Indonesia    Negara :   Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, Democractic Republic of the Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia (Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Islas Malvinas) Faroe Islands Fiji Islands Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong S.A.R. 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Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea Korea, North Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau S.A.R. Macedonia, Former Yugoslav Republic of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Antilles Netherlands, The New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua new Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts And Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent And The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And The South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis And Futuna Islands Yemen Yugoslavia Zambia Zimbabwe    Kode Pos :      Telepon Rumah :        Telepon Kantor :        Facsimile :        HandPhone :      Alamat e-mail :   Buat User Id Anda    User ID :      Password :      Konfirmasi Password :      Kirim Informasi :   Ya     Tidak Lupa Password    Pertanyaan :   Warna Favorit Kota Favorit Nama Ibu Kandung    Jawaban :

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